Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

Purpose – The purpose of this paper is to design and analyze four proximal interphalangeal joint (PIP) prosthesis thorough finite element analysis (FEA) and fabricate them using rapid prototyping (RP) technique. Arthritis of the finger joints is an important pathology of the hand. Major complaints in arthritis are stiffness, deformity and severe pain. The pain is due to the inflammatory process that occurs due to pathology, which involves joint degeneration, synovial swelling and ligament and muscle stiffness. Among the surgical treatment of arthritis is Arthroplasty which involves replacing the diseased joint with an artificial joint. Design/methodology/approach – In this paper, four proximal interphalangeal joint (PIP) prostheses are designed, analyzed using FEA and fabricated using rapid prototyping technique. Four different prostheses “BM”, “IMP”, “IMP2” and “FINS” are designed using CATIA software and tested by normal daily functions such as grasp, key pinch and tip pinch tests using FEA to analyze the results based on their stress and deformation. Finally, the prostheses are fabricated using electron beam melting technology. Findings – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant. The ANSYS summary results were analyzed depending on the minimal results of equivalent stress and deformation from the taken tests that have happened on the designed prosthesis. The results conclude that, in the grasp test, the minimal equivalent stress and deformation have happened on the “BM” and “IMP2” implants. Furthermore, in the key pinch test, minimal equivalent stress and deformation occurred on the “FINS” implant, and finally, in the tip pinch, minimal equivalent stress occurred on the “FINS” and minimal deformation has happened on the “IMP2” implant. Research limitations/implications – These results conclude that both “IMP2” and “FINS” share the minimum results in the taken tests, and this shows that these implants may be further studied brainstormed upon to aid innovation of a better implant design that shares both of these implants’ features and shape. Nevertheless, testing in an in vivo or in vitro model to prove more of the effectiveness of these implants should be taken into consideration, and to test how the prostheses will function in an actual environment, a simulated hand can be designed and made to discover the true forces and mechanics of the fingers and the hands with the prosthesis that is implanted, as well as to know if the hand works properly. Originality/value – This paper examined and analyzed the relative motion of PIP designs using FEA by applying varying loads to check the stability and range of motion of the PIP implant.

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Morphological Measurements of the Proximal Interphalangeal Joint

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2004.01.010 ◽

2004 ◽

Vol 29 (3) ◽

pp. 242-247 ◽

Cited By ~ 15

Author(s):

T. LAWRENCE ◽

I. A. TRAIL ◽

J. NOBLE

Keyword(s):

Articular Surface ◽

Proximal Phalanx ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Implant Design ◽

Radius Of Curvature ◽

Middle Phalanx ◽

Photographic Technique ◽

Articular Surfaces ◽

Palmar Surface

The morphology of the proximal interphalangeal joint was determined using a photographic technique. The head of the proximal phalanx, viewed end on, has a complex trapezoid appearance characteristic for each named digit. The asymmetric condyles diverge from one another and are separated by an intercondylar groove that increases in depth from the dorsal to the palmar surface. Saggital sections of the head of the proximal phalanx are not circular, but, sections taken in the plane of maximum dimensions of the condyle are circular with a radius of curvature of approximately one half of the height of the condyles. The articular surface of the base of the middle phalanx is not circular in outline in either the saggital or coronal plane. In coronal sections the articular surface is biconcave convex with a prominent median ridge separating the two adjacent concave articular surfaces. The implications of this varied morphology on implant design are discussed.

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Arthroplasty in the hand: what works and what doesn’t?

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211017703 ◽

2021 ◽

pp. 175319342110177

Author(s):

Daniel B. Herren ◽

Hajime Ishikawa ◽

Marco Rizzo ◽

Mark Ross ◽

Michael Solomons

Keyword(s):

Surgical Technique ◽

Metacarpophalangeal Joint ◽

Distal Radioulnar Joint ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Carpometacarpal Joint ◽

Thumb Carpometacarpal Joint ◽

Radioulnar Joint ◽

What Works ◽

Thumb Carpometacarpal

This review describes the different possibilities for arthroplasties at the proximal interphalangeal joint, thumb carpometacarpal joint, distal radioulnar joint, metacarpophalangeal joint and the wrist. For each joint, the indication for arthroplasty is explained, the surgical technique with the suitable implant is described and a brief summary of the outcomes reported in the literature is given.

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A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽

10.1177/17589983211018717 ◽

2021 ◽

pp. 175899832110187

Author(s):

Kawee Pataradool ◽

Chayanin Lertmahandpueti

Keyword(s):

Outcome Measures ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Mean Difference ◽

Trigger Finger ◽

Symptom Improvement ◽

Dash Score ◽

Full Time ◽

Custom Made ◽

Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

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A Sliding Flap to Cover Dorsal Skin Defects Over the Proximal Interphalangeal Joint

HAND ◽

10.1016/s0072-968x(82)80060-0 ◽

1982 ◽

Vol os-14 (3) ◽

pp. 271-278 ◽

Cited By ~ 14

Author(s):

P. J. Smith

Keyword(s):

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Dorsal Skin ◽

Skin Defects

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Post-Reduction Stability of the Proximal Interphalangeal Joint after Dorsal Fracture Dislocation—A Cadaveric Study

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835516500387 ◽

2016 ◽

Vol 21 (03) ◽

pp. 382-387 ◽

Cited By ~ 1

Author(s):

Andre Eu-Jin Cheah ◽

Tun-Lin Foo ◽

Janice Chin-Yi Liao ◽

Min He ◽

Alphonsus Khin-Sze Chong

Keyword(s):

Traction Force ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Fracture Dislocation ◽

Treatment Modalities ◽

Full Extension ◽

Early Motion ◽

Fracture Dislocations ◽

Reduction Stability ◽

The One

Background: Proximal interphalangeal joint (PIPJ) dorsal fracture dislocations (DFD) are challenging injuries. Treatment aims to achieve stability of the PIPJ after reduction so that early motion can be initiated. We studied how increasing articular destruction would affect post reduction stability and investigate the amount of traction and PIPJ flexion needed to maintain the reduction. Methods: Increasing amounts (20%, 40% and 60%) of damage to the volar lip of the middle phalanx in cadaveric specimens were created to represent PIPJ DFD that were stable, of tenuous stability and frankly unstable. Traction forces and PIPJ flexion needed to maintain the reduction were then measured. Results: The PIPJ DFD with 20% damage were stable and did not subluxe while the one with 40% articular involvement was stable after reduction. For unstable the PIPJ with 60% involvement, the more the PIPJ was flexed, the less traction force was needed to hold the joint in reduction. For PIPJ flexion of 20 degrees, a minimum 4.4N of force is needed to maintain reduction while PIPJ flexion of 10 degrees required a minimum 5.0N of force. No amount of force could maintain PIPJ reduction if traction was performed in full extension. Conclusions: In our model, PIPJ DFD with less than 30% articular damage are stable while those with 30% to 50% of involvement have tenuous stability. For the unstable PIPJ DFD, traction obviates the need for excessive flexion of the PIPJ to maintain joint reduction. This information should be considered in treatment modalities for PIPJ DFD, as well in the design of external traction devices for the treatment of PIPJ DFD.

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Results of Vascularized Joint Transfers from the Foot

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(97)80275-6 ◽

1997 ◽

Vol 22 (4) ◽

pp. 492-498 ◽

Cited By ~ 7

Author(s):

G. DAUTEL ◽

M. MERLE

Keyword(s):

Joint Space ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Indications For Surgery ◽

Pip Joint ◽

Prosthetic Implant ◽

Metatarsophalangeal Joints ◽

Second Toe ◽

The Average Range

We report our results in ten cases of vascularized joint transfer to reconstruct the proximal interphalangeal joint (five cases) or metacarpophalangeal joints (five cases). Donor sites were the proximal interphalangeal or the metatarsophalangeal joints of the second toe. Indications for surgery were the need to reconstruct both the growth plate and joint space in children or the impossibility of a conventional prosthetic implant. The average range of motion was 44° for the PIP joint and 53° for the MP joint at a mean follow-up of 22.7 months.

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Proximal interphalangeal joint silicone arthroplasty for posttraumatic arthritis

Journal of Orthopaedic Science ◽

10.1007/s00776-007-1154-x ◽

2007 ◽

Vol 12 (5) ◽

pp. 493-496 ◽

Cited By ~ 3

Author(s):

Daisuke Yamauchi ◽

Kazuo Ikeda ◽

Katsuro Tomita ◽

Shinjiro Amaya

Keyword(s):

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Posttraumatic Arthritis

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Results of Treatment of Chronic Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joints of the Fingers

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80101-0 ◽

1998 ◽

Vol 23 (6) ◽

pp. 798-801 ◽

Cited By ~ 11

Author(s):

O. ISHIDA ◽

Y. IKUTA

Keyword(s):

Articular Cartilage ◽

Internal Fixation ◽

Open Reduction ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Fracture Dislocation ◽

Results Of Treatment ◽

Palmar Plate ◽

Fracture Dislocations

We reviewed 20 cases of chronic dorsal fracture-dislocation of the proximal interphalangeal joint, with a mean follow-up period of 74 months. In patients without comminuted palmar fragments, open reduction and internal fixation or osteotomy of the malunited fragment provided good results. In treating patients with damaged articular cartilage or with comminuted palmar fragments by palmar plate arthroplasty, poor results were obtained because of secondary osteoarthritic changes.

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